Scalp Biopsy for Hair Loss: Procedure, Purpose, and Side Effects
A doctor may recommend a scalp biopsy if they suspect a medical condition could be causing your hair loss.
Many people lose their hair as they get older due to their genetics. But for some, hair loss can be caused by an underlying medical condition.
A scalp biopsy involves taking a small sample of skin from your scalp, including hair follicles. The sample is then sent to a laboratory to help determine the cause of your hair loss.
You may feel some discomfort during the injection of anesthetic, bit it lasts only a few seconds. The biopsy process should only take a few minutes in all. You’ll be able to go home immediately afterward.
Read on to learn more about scalp biopsy, when it’s recommended, and what to expect.
What can a scalp biopsy detect?
A biopsy of the skin on your scalp can help a doctor see any signs of damage to the follicles that could account for hair loss. It can also detect or rule out an autoimmune condition or other skin condition that could be affecting your scalp, including an infection or inflammation.
Conditions that a scalp biopsy may help detect include:
- alopecia areata
- telogen effluvium
- trichotillomania
- traction alopecia
- scarring (or cicatricial) alopecia
- lichen planopilaris
- scalp infection, including tinea capitis (ringworm)
- inflammation
- male pattern hair loss
- female pattern hair loss
Keep in mind that hair growth and hair loss is a complicated process. A doctor will likely use the information from your scalp biopsy combined with your health and family history and a physical exam to help determine the cause of your hair loss.
Scalp biopsy for hair loss side effects and risks
A scalp biopsy involves taking very small samples of skin from your scalp. Though the procedure is very safe, there can be risks, including:
Infection
Symptoms of an infection may include:
- pain
- swelling
- skin warmth
- discharge or pus
- fever
Make sure to follow a doctor’s aftercare instructions to prevent an infection. This may include gently washing the biopsy site with soap and water, patting dry, and covering the wound with sterile gauze or a bandage. Speak with a doctor right away if you think the biopsy site has become infected.
Bleeding
The biopsy site might continue to bleed after you leave a doctor’s office. If this occurs, apply direct pressure to the wound for 20 minutes using a sterile gauze pad. If bleeding continues, call a doctor.
Scalp biopsy scar
A permanent scar will form where your skin was cut and stitched together. The scar will typically be very small.
How effective is a scalp biopsy for hair loss?
A scalp biopsy can be very helpful in diagnosing hair loss, especially when the cause of your hair loss isn’t obvious. But it’s just one piece of the puzzle.
By analyzing the tissue sample, a doctor can have a better understanding of the factors contributing to hair thinning or loss. But this information is combined with a clinical examination and possibly other tests before reaching a conclusion.
Preparing for a scalp biopsy for hair loss
Be sure to tell a doctor if you’re taking any medications. They may ask you to stop taking them in the weeks before your biopsy.
The day before your scalp biopsy, wash your hair to help prevent infection. Avoid applying hair products, like gel or mousse, before your procedure.
Scalp biopsy for hair loss procedure
A scalp biopsy is an outpatient procedure, meaning it can be done at a doctor or dermatologist’s office. The biopsy itself only takes a few minutes.
There are three types of biopsy techniques:
- Punch biopsy: A punch biopsy uses a small circular tool to remove a core of skin, including deeper layers.
- Shave biopsy: A shave biopsy uses a razor blade to scrape the surface of your skin and only takes a sample from the top layers.
- Excisional biopsy: An excisional biopsy uses a scalpel to remove an entire area of irregular skin.
In general, the doctor will:
- disinfect and numb the area with an injection (you might feel some burning or stinging as the numbing agent is injected)
- remove one or more small pieces of skin using one of three techniques
- apply pressure to stop bleeding
- depending on the type of biopsy, close the wound with stitches, a bandage, or ointment
The doctor will then send the sample to a lab, where it will be examined under a microscope.
A doctor may schedule an appointment for you to come back later to have your stitches removed. Some stitches will dissolve on their own.
Recovering from scalp biopsy
You can go back to work right after the procedure. Your scalp may be sore or tender, but you shouldn’t have any pain. Keep the wound dry on the day of the biopsy and monitor it for bleeding.
If bleeding occurs, apply pressure with a sterile gauze. A doctor may give you an antibiotic ointment to apply on the wound. Be sure to follow the doctor’s instructions for applying the ointment and cleaning your wound site.
The day after your procedure, wash your hair with mild soap or shampoo and water. Don’t use harsh products or expose the area to unnecessary heat.
Other tests to diagnose hair loss
Diagnosing the cause of hair loss is complex. A doctor may decide to perform a biopsy in combination with other tests or to use other diagnostic tools and tests instead of a biopsy. Other diagnostic tools for hair loss include:
- Physical exam and medical history: A standard physical examination could identify common causes of hair loss, like male pattern baldness.
- Pull or tug tests: A doctor will tug or pull a small section of your hair and count how many hairs are pulled out or if the hair breaks. This test can help them understand if you’re in active hair loss or if your hair is fragile.
- Card test: A small card is placed on your scalp against the hair shafts to help differentiate newly growing hairs from broken hairs. This test allows a doctor to determine the health of the hair shaft and to see how many hairs are newly growing.
- Trichometric analysis: A doctor takes pictures of your scalp and hair and examines the images on a computer monitor. The images are magnified, providing a detailed look at your hair, hair follicles, and scalp.
- Fungal culture: If you exhibit symptoms of a skin infection like tinea capitis, a doctor will swab the area and send it to a lab for testing.
- Blood tests: Blood tests can check for any lack of nutrients or an underlying condition that can be causing hair loss.
Frequently asked questions about scalp biopsy for hair loss
Here are answers to some frequently asked questions about scalp biopsy for hair loss.
Can a scalp biopsy diagnose the cause of hair loss?
Yes, a scalp biopsy can diagnose the cause of hair loss. Doctors often perform a biopsy when a physical exam and other tests aren’t enough to confirm the cause.
Is a scalp biopsy worth it?
Scalp biopsies aren’t needed for everyone with hair loss but can be worth it if a doctor can’t confirm a diagnosis with other tests. While a biopsy can be helpful, it does have limitations and causes a small scar at the biopsy site. Discuss the risks and benefits with a doctor before the procedure.
Will hair grow back after scalp biopsy?
Hair from the shaved area will grow back, but it may take several months. A punch biopsy will leave a small scar, and hair won’t be able to grow back from this area. For this reason, speak with a doctor about taking the biopsy from an area of your scalp that is easy to hide.
How long does a scalp biopsy take to heal?
Most wounds from a scalp biopsy heal in 7 to 10 days. A doctor may place dissolvable stitches to close the wound. Keep in mind that these stitches could take several weeks to dissolve fully.
How much does a scalp biopsy cost, and is it covered by insurance?
The cost of a scalp biopsy will vary depending on your location. For example, Dermatology Circle in New York City charges $425 for an initial hair loss consultation and an additional $99 if a scalp biopsy is needed, but there may be additional fees. Donovan Hair Clinic in Canada charges $575 per biopsy, but this doesn’t include the cost of the initial consultation.
Health insurance typically covers hair loss diagnosis and treatment of medical conditions like alopecia areata.
What is a scalp biopsy?
A scalp biopsy is a medical procedure used to diagnose the cause of hair loss by examining a small sample of skin and hair from the scalp under a microscope.
Why is a scalp biopsy performed?
A scalp biopsy is performed to diagnose conditions causing hair loss, such as alopecia areata, scarring alopecia, and other scalp disorders, by providing detailed information about the hair follicles and scalp tissue.
How is a scalp biopsy procedure conducted?
The procedure involves numbing the scalp with a local anesthetic, then removing a small, circular section of scalp tissue using a tool called a punch biopsy. The sample is then sent to a laboratory for analysis.
What should I expect during a scalp biopsy?
During a scalp biopsy, you will feel mild pressure but should not experience pain due to the local anesthetic. The procedure typically takes about 15-30 minutes.
What are the aftercare steps following a scalp biopsy?
After a scalp biopsy, you should keep the biopsy site clean and dry, follow any specific care instructions provided by your doctor, and monitor for signs of infection such as redness or unusual discharge.
What are the potential side effects of a scalp biopsy?
Side effects of a scalp biopsy may include mild pain or discomfort, bleeding, infection at the biopsy site, and minor scarring.
How long does it take to get results from a scalp biopsy?
Results from a scalp biopsy typically take about 1-2 weeks, as the sample needs to be processed and analyzed in a laboratory.
Is a scalp biopsy painful?
Most patients experience minimal pain during a scalp biopsy because the area is numbed with a local anesthetic. Some discomfort may occur after the procedure as the numbing wears off.
Can a scalp biopsy help with treatment planning?
Yes, a scalp biopsy can help determine the specific cause of hair loss or scalp condition, enabling doctors to tailor an effective treatment plan based on accurate diagnosis.
Takeaway
A scalp biopsy is one of many tools a doctor can use to determine the cause of your hair loss, especially if there’s no clear reason for it. During a scalp biopsy, a doctor removes a small piece of skin from your scalp for further testing and analysis. This in-office procedure is considered safe and only takes a few minutes.
This article provides a comprehensive overview of scalp biopsies for hair loss, detailing the procedure, its purpose, and potential side effects. It’s incredibly helpful for those considering this diagnostic method, as it outlines what to expect and helps in making an informed decision. I appreciate the balanced information on both the benefits and risks involved, which is crucial for understanding whether this is the right step for one’s hair loss issues. Thank you for this insightful post!
This is a very informative post! Understanding the reasons behind hair loss and the process involved in scalp biopsies can really help demystify the experience for those who are anxious about it. It’s particularly helpful how you broke down the procedure step-by-step and explained the potential side effects. Knowing what to expect can alleviate a lot of the stress surrounding medical procedures. Thank you for sharing these insights!
This was an incredibly informative read! I had no idea how crucial a scalp biopsy could be in diagnosing different types of hair loss. It’s reassuring to know that the procedure isn’t too invasive and can provide such valuable insights. The section on potential side effects was also helpful to set the right expectations. Thanks for shedding light on this important topic!
This is a very informative post! Understanding the details of a scalp biopsy can be really helpful for anyone experiencing significant hair loss and seeking answers. It’s great to see an explanation of both the procedure and the potential side effects. This kind of information can help individuals make informed decisions and discuss options with their healthcare providers more effectively. Thank you for sharing!
Thank you for this informative post! It really helped me understand the purpose and process of a scalp biopsy for hair loss. It’s great to know that the procedure can provide insights into the underlying causes of hair loss. I’m a bit concerned about the potential side effects, though. Are there any tips on how to minimize discomfort or care for the scalp post-biopsy?